Defensive medicine
REES, MATTHEW
Defensive Medicine by Matthew Rees In 1994 Sen. Phil Gramm of Texas vociferously opposed the Clinton health-care plan. "Anything I can do within the rules of the Senate to prevent the government...
...The problem for Republicans is simple: Healthcare issues are potent...
...The other big problem for Republicans is Hatch...
...There's a high potential for dema-goguery here...
...When there's a bidding war, Republicans lose," says Tanner...
...That's what they have to do this time as well...
...Molinari wants to make them cover the duration of a woman's post-mastectomy hospital stay, as determined by the physician and the patient...
...Having established that his opponents are misanthropes, Hatch then asked, on the ABC program This Week, "You mean we can't do anything about health care because it might involve the government and might involve raising some monies in order to pay for health care for kids...
...An indication of how hard this will be to vote against: Lauch Fair-cloth is supporting it...
...Last week, he and Kennedy introduced their bill as an amendment to the budget agreement...
...AFL-CIO president John Sweeney has warned that if Republicans "don't come around, we'll use children's health the way we used Medicare, and that's a promise and a commitment...
...They're especially reluctant to fight an incremental health reform to be paid for with a tax on cigarettes...
...Tanner and others note that while 10 million children may be uninsured, up to 15 percent of them are in families earning more than $40,000 annually, and another 30 percent qualify for Medicaid but have failed to enroll...
...After successfully resisting the Clinton administration's proposal in 1993-94, Republicans have lost their moorings and mostly capitulated to the Democratic argument that coverage for the uninsured—particularly children—is best achieved through an expanded role for government...
...But that could get expensive...
...Anything I can do within the rules of the Senate to prevent the government from taking over or controlling the health-care market," he declared, "I'm going to do, and I'm going to do it proudly...
...Kennedy says providing health coverage for uninsured children "is the most important program for this Congress to enact," and minority leader Tom Daschle says if Republicans don't acquiesce Democrats will offer their health-care proposals as amendments to other bills, as they did this week to the budget resolution...
...Senate Republican leader Trent Lott says Gramm's proposal is "better than anything else I've seen...
...Similarly, few Republicans are talking about a reform that would reduce the number of uninsured: changing the tax code to give health coverage for the self-employed (and the unemployed) the same tax break as employer-provided health care...
...There was lots of soothing talk about the GOP's family-friendly policies on subjects ranging from tax relief and crime to juvenile justice and education...
...Salmon has a bill to lift all eligibility restrictions for medical savings accounts, and Rep...
...But after being pilloried for a year and a half over their laudable attempt to slow the growth of Medicare, Republicans are inclined to take a pass...
...Which way are Republicans leaning...
...It has continued this year...
...Olympia Snowe and Rep...
...He's been relentless in his efforts...
...Susan Molinari...
...But in the midst of all the public-policy cheerleading, two words never passed the Republicans' lips: health care...
...But in April 1997, the same Sen...
...The amendment failed, as Lott forced Clinton to oppose it for the sake of getting the budget resolution passed, but Hatch promises to "press forward at every opportunity...
...Jim Jeffords, the Labor and Human Resources chairman, is expected to introduce a sweeping health-care bill sometime this year (Jeffords was the sole Republican cosponsor of the Clinton health-care plan...
...While the budget agreement contains $16 billion in new spending for uninsured children, congressional Democrats aren't stopping there...
...Republicans are fighting on the wrong terms," complains Mike Tanner, a health-care analyst at the libertarian Cato Institute, "responding to a problem that doesn't exist...
...But because these bills have only lukewarm support from the Republican leadership and will encounter fierce Democratic opposition, they're given much less chance of passage than are the mandates extending coverage...
...The trend began last year, when Republicans approved mandates requiring health insurers to treat mental disorders the same as other ailments and to cover at least 48 hours in the hospital for new mothers...
...Gramm proposed a bill that would double federal funding for maternal and child-health block grants, while doing little to promote free-market reforms such as medical savings accounts or to address a fundamental problem in health care: the tax code...
...And then there are the proposals of two other Republicans, Sen...
...It's hard to blame them: An NBC/Wall Street Journal poll found 72 percent support for raising the cigarette tax to pay for health coverage for uninsured children—the centerpiece of the major Senate initiative proposed by conservative Republican Orrin Hatch and liberal Democrat Ted Kennedy...
...He's one of the most conservative Senate Republicans, and he's up for reelection next year...
...One problem for Republicans is that many of the questionable proposals come from their own ranks...
...When he announced his support for the Kennedy bill at a Children's Defense Fund conference in March, he said he wanted to prove the Republican party "does not hate children...
...That fact reflects the GOP's new squishi-ness on health care...
...the insurance company, in other words, is cut out of the picture except to foot the bill...
...There's been no conservative leadership on these issues," says Carrie Gavora of the Heritage Foundation...
...The first is to continue down the present path, which means conceding the Democratic argument for government provision of health care and then working to minimize the damage...
...They were for affordability and portability...
...Even Lott concedes that while these mandates "are expensive and very questionable," some of them "may be defensible or appropriate...
...Harris Fawell of Illinois proposes to allow the pooling of small businesses that are otherwise unable to provide affordable health insurance...
...Gathered on a lawn outside the Capitol to showcase their commitment to children and families were representatives Deborah Pryce, Kay Granger, Anne Northup, Molinari, and House majority leader Dick Armey...
...A recent Pew Research poll showed affordable health care to be the country's leading source of anxiety, ahead of crime and job security...
...Conversely, Republicans can highlight the flaws in the Democratic proposals and introduce market-oriented reforms of their own...
...Yet few Republicans want to argue against expanding Medicaid eligibility, even though such expansion creates incentives for families and employers to drop their private coverage and rely on government...
...Gramm was key in defeating Clintoncare...
...Alfonse D'Amato wants new regulations on HMOs...
...Snowe wants to require health insurers to cover contraceptives...
...In cosponsoring a bill with Kennedy, he's pushed the discussion dramatically leftward...
...If Republicans are going to avoid turning health care into a political liability, they have two options...
...Barbour also notes that notwithstanding Medicare, the single most Republican age group in last year's congressional elections were voters 65 and older...
...One clue comes from an event sponsored by the House GOP leadership on May 22...
...Haley Barbour, the former party chairman, recalls that among the reasons Republicans succeeded in defeating the Clinton plan in 199394 was that "they refused to let themselves be seen as against health care...
...Arlen Specter wants to create a $10 billion trust fund for block grants to the states to pay for health-insurance vouchers...
...These proposals wouldn't be so worrisome except that Republicans are offering few alternatives...
...Who wants to vote against that...
...We seem to want to offer scaled-down Democratic initiatives instead of our own innovative proposals," says Matt Salmon, a secondterm House member from Arizona...
...Matthew Rees is a staff writer for The Weekly Standard...
...But the issue isn't going away...
...And he's not allowing fellow Republicans much room to maneuver...
Vol. 2 • June 1997 • No. 37
